escitalopram

Pronunciation

Generic Name: escitalopram (EE sye TAL o pram)
Brand Name: Lexapro

What is escitalopram?

Escitalopram is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Escitalopram affects chemicals in the brain that may become unbalanced and cause depression or anxiety.

Escitalopram is used to treat anxiety in adults. Escitalopram is also used to treat major depressive disorder in adults and adolescents who are at least 12 years old.

Escitalopram may also be used for purposes not listed in this medication guide.

What is the most important information I should know about escitalopram?

You should not use this medicine if you also take pimozide, or if you are being treated with methylene blue injection.

Do not use escitalopram if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

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Some young people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using escitalopram. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Escitalopram should not be given to a child younger than 12 years old.

What should I discuss with my healthcare provider before taking escitalopram?

It is dangerous to try and purchase escitalopram on the Internet or from vendors outside of the United States. Medications distributed from Internet sales may contain dangerous ingredients, or may not be distributed by a licensed pharmacy. Samples of escitalopram purchased on the Internet have been found to contain haloperidol (Haldol), a potent antipsychotic drug with dangerous side effects. For more information, contact the U.S. Food and Drug Administration (FDA) or visit www.fda.gov/buyonlineguide.

You should not use this medicine if you are allergic to escitalopram or citalopram (Celexa), or if:

  • you also take pimozide; or

  • you are being treated with methylene blue injection.

Do not use escitalopram if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine. After you stop taking escitalopram, you must wait at least 14 days before you start taking an MAOI.

To make sure escitalopram is safe for you, tell your doctor if you have:

  • liver or kidney disease;

  • seizures or epilepsy;

  • diabetes;

  • heart disease;

  • bipolar disorder (manic depression); or

  • a history of drug abuse or suicidal thoughts.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using escitalopram. Your family or other caregivers should also be alert to changes in your mood or symptoms.

FDA pregnancy category C. Taking an SSRI antidepressant during pregnancy may cause serious lung problems or other complications in the baby. However, you may have a relapse of depression if you stop taking your antidepressant. Tell your doctor right away if you become pregnant while taking escitalopram. Do not start or stop taking this medicine during pregnancy without your doctor's advice.

Escitalopram can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Escitalopram should not be given to a child younger than 12 years old.

How should I take escitalopram?

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Try to take the medicine at the same time each day. Follow the directions on your prescription label.

Measure liquid medicine with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

It may take up to 4 weeks or longer before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.

Do not stop using escitalopram suddenly, or you could have unpleasant withdrawal symptoms. Follow your doctor's instructions about tapering your dose.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking escitalopram?

Avoid taking tryptophan while you are taking escitalopram.

Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others. Using an NSAID with escitalopram may cause you to bruise or bleed easily.

Drinking alcohol can increase certain side effects of escitalopram.

Escitalopram may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Escitalopram side effects

Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

  • very stiff (rigid) muscles, high fever, sweating, fast or uneven heartbeats, tremors, feeling like you might pass out;

  • nausea, vomiting, diarrhea, loss of appetite, feeling unsteady, loss of coordination;

  • racing thoughts, unusual risk-taking behavior, feelings of extreme happiness or sadness; or

  • headache, trouble concentrating, memory problems, weakness, confusion, hallucinations, fainting, seizure, shallow breathing or breathing that stops.

Common side effects may include:

  • drowsiness, tired feeling;

  • sleep problems (insomnia);

  • mild nausea, gas, heartburn, upset stomach, constipation;

  • weight changes;

  • decreased sex drive, impotence, or difficulty having an orgasm; or

  • increased sweating.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Escitalopram Dosing Information

Usual Adult Dose for Anxiety:

10 mg orally once a day in the morning or evening with or without food.

The dose may be increased to 20 mg, after a minimum of one week.

Escitalopram (10 to 20 mg orally daily) has been shown to be well tolerated and effective in the treatment of generalized anxiety disorder for up to 6 months.

Usual Adult Dose for Depression:

10 mg orally once a day in the morning or evening with or without food.

The dose may be increased to 20 mg, after a minimum of three weeks.

Usual Pediatric Dose for Depression:

12 to 17 years:

10 mg orally once a day in the morning or evening with or without food.

The dose may be increased to 20 mg, after a minimum of three weeks.

What other drugs will affect escitalopram?

Taking escitalopram with other drugs that make you sleepy or slow your breathing can increase these effects. Ask your doctor before taking escitalopram with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with escitalopram, especially:

  • any other antidepressant;

  • buspirone;

  • lithium;

  • St. John's wort;

  • tryptophan (sometimes called L-tryptophan);

  • a blood thinner such as warfarin, Coumadin;

  • migraine headache medication--sumatriptan, rizatriptan, and others; or

  • pain medication--fentanyl or tramadol.

This list is not complete. Other drugs may interact with escitalopram, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about escitalopram.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 15.02. Revision Date: 2013-05-30, 8:33:16 AM.

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